Healthcare Provider Details

I. General information

NPI: 1730758681
Provider Name (Legal Business Name): OCEAN-1 HOME HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 NW 103RD AVE STE 200
SUNRISE FL
33351-7947
US

IV. Provider business mailing address

4545 NW 103RD AVE STE 200
SUNRISE FL
33351-7947
US

V. Phone/Fax

Practice location:
  • Phone: 954-210-7961
  • Fax: 954-719-7191
Mailing address:
  • Phone: 954-210-7961
  • Fax: 954-210-7974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LORNA OSBORNE
Title or Position: PRESIDENT
Credential:
Phone: 954-210-7961